Does Insurance Cover Varicose Vein Removal?

Vein procedures are generally a covered benefit by most insurance types (including Medicare) if they are considered medically necessary. Medical necessity requirements varies by the individual policy, but in general the varicose veins must cause symptoms such as leg pain, heaviness, fatigue, aching, restless legs, swelling or skin changes such as darkening of the skin around the ankles. Sometimes varicose veins can cause  complications such as phlebitis, bleeding, ulceration or skin changes; these are considered medical conditions. If varicose veins do not cause symptoms, they are considered to be a cosmetic issue in the eyes of insurance.

An ultrasound examination is necessary to provide an overall assessment of the severity of the vein condition. This is a diagnostic study and usually covered by insurance.

In most cases, insurance companies require that conservative measures have been tried for several weeks. Conservative measures include compression stockings, leg elevation, exercise, weight loss or maintaining a healthy weight, NSAIDS or other medication and hot/cold packs.  Many insurance types REQUIRE 6 to 12 weeks of wearing medical grade compression stockings prior to being approved for treatment.

Sometimes, flexible spending accounts can be used to pay for or may reimburse for compression stockings, varicose veins and spider vein treatments.

For more insurance information and questions, email

LJVC Welcomes Hilary Black, RN

LJVC welcomes Hilary Black, RN! Hilary has worked with LJVC for a few months now in our cosmetic spider vein clinic, helping patients get rid of unsightly spider veins on the legs.  Hilary also continues to work with Dr. Sadrian, plastic surgeon.  She  received her Bachelor of Science in Business from U.S.C. in Los Angeles prior to graduating from Maric College of Nursing in San Diego.  Hilary worked on the cardiac care (telemetry) unit immediately after graduating from nursing school before she joined the aesthetic world. Since then she has worked for over 12 years in the aesthetic arena.   Her experience includes the use of many state of the art lasers and injectibles, including those for vein treatment.   She has worked with and continues to work beside surgeons to provide specialized aesthetic treatment plans for her patients.  She has performed thousands of procedures and strives to provide a beautiful and lasting result for each patient.Hilary lives in Carmel Valley and enjoys spending time with her niece and nephews, shopping, reading, traveling and going out with friends.

To schedule an appointment with Hilary in our cosmetic spider vein clinic, please call 858-550-0330. Summer’s around the corner, and leg vein conditions  may take more than one treatment and several weeks-months for best results.

Meet La Jolla Vein Care’s Dr. Fronek, Vein Specialist

Helane Fronek MD, FACP, FACPh is one of La Jolla Vein Care’s esteemed board certified vein specialist.  Dr. Fronek _NOR1964entered the field of phlebology in 1985 and has been an integral part of the development of this new medical specialty. As the Director of the Varicose Vein Clinic at Scripps Clinic, she provided cutting edge treatment for the entire spectrum of superficial venous disorders and conducted research on venous leg ulceration, compression therapy, and emerging therapies for varicose veins. Dr. Fronek is a past president of the American College of Phlebology, the largest medical organization devoted to vein care. She is a respected speaker and educator in all aspects of diagnosis and treatment for venous disease and communication in the medical arena.

Dr. Fronek was the first recipient of the American College of Phlebology’s prestigious Leadership Award. In 2011, Dr. Fronek was honored for her contribution to the field of phlebology and named an honorary member of the ACP. This award is given to one leader in the field, amongst national and international members.

Board-certified in both Internal Medicine and Phlebology, she is also Assistant Clinical Professor of Medicine at UC-San Diego School of Medicine, where she teaches medical students the practice of physical examination and the art of medicine. Dr. Fronek has dedicated her career to providing technically excellent and compassionate care to her patients and to inspiring and teaching the next generation of phlebologists. Dr. Fronek is well known for authoring, ‘The Fundamentals of Phlebology’ which is a medical textbook used by most Phlebologists entering the field.

Dr. Fronek is accepting new patients. To make an appointment with Dr. Fronek, call 858-550-0330.


Dr. Nisha Bunke

Meet Dr.Bunke, La Jolla Vein Care Specialist

Dr. Nisha Bunke

Dr. Nisha Bunke Paquette, MD, FACPh is one of La Jolla Vein Care’s highly trained board-certified venous disease specialist.  Dr. Bunke specializes in highly advanced and minimally invasive outpatient procedures for treating a wide spectrum of venous conditions. Dr. Bunke  is one of a few southern California physicians board-certified and fellowship trained in Venous and Lymphatic Medicine. She was the first physician in the United States to complete fellowship training supported by the American College of Phebology and was mentored by world renowned vascular surgeon, Dr. John Bergan. Presently, she sees patients at La Jolla Vein Care, San Diego County’s largest dedicated vein center.  She is also a Volunteer Clinical Instructor of Surgery at the University of California San Diego (UCSD) School of Medicine, member of the Scripps Ximed Medical Group and Veteran’s (VA) Medical Center. For five years, Dr. Bunke  has run the vein clinics at the VA Medical Center, providing vein care for our veterans. From 2010 until 2012, she also directed UCSD’s Vein Clinic.

Dr. Bunke is a physician and scientist, actively leading clinical research studies. In 2009, Dr. Bunke  was awarded the Internationale Union of Phlebologie Research Fellowship and the Best Young Presenter Award in Monaco. Collectively, Dr. Bunke  and Dr. Bergan were awarded the 2008 JOBST Research Award for the Advancement of Phlebology for their research on Inflammatory Bio-Markers of Venous Insufficiency. Moreover, Dr. Bunke-Paquette is a member of The Clinical and Translational Research Institute (CTRI) of the University of California San Diego (UCSD), the American Medical Association (AMA), San Diego County Medical Society, Society for Vascular Medicine, American College of Phlebology (ACP), American Venous Forum (AVF) and the Society for Vascular Ultrasound (SVU).  She has published chapters in several medical textbooks, academic journals and most recently co-edited the second edition of the Vein Book, along with John Bergan.

To make an appointment to see Dr. Bunke, call 858-550-0330. 065_NOR2320


Spider Vein Sclerotherapy: Before & After Photos

Before and after pictures of spider veins that were treated with sclerotherapy.

Before and after pictures of spider veins that were treated with sclerotherapy. This patient had spider veins behind the knees, which is a common location for spider veins and larger blue, ‘reticular veins.’

Spider vein patient treated at La Jolla Vein Care with sclerotherapy.

Spider vein patient treated at La Jolla Vein Care with sclerotherapy. Notice the presence of a blue ‘feeder vein’ that gives rise to the spider veins. It is important to treat ‘feeder veins’ to successfully eliminate the spider veins. It is similar to ‘pulling the root’ of a weed rather than clipping the weed to eliminate it.

Spider vein patient treated at La Jolla Vein Care with sclerotherapy. Note that spider veins can vary in size, location and severity. Depending on the severity of the condition, multiple treatment sessions may be required for optimal
Note that spider veins can vary in size, location and severity. This patient had a large cluster of spider veins that appear as a bluish-purple discoloration on the outside of the knee. This patient has bruising after treatment which will fade over several weeks.


New Cosmetic Spider Vein Clinic

While the doctors at La Jolla Vein Care are committed to advancing vein care through medicine, education and research (Dr. Bunke just published the 2nd edition of the Vein Book and Dr. Fronek remains an integral part of the American College of Phlebology), we are pleased to offer our new RN/ PA (Registered Nurse/ Physician Assistant) cosmetic sclerotherapy clinic for simple spider vein conditions offered on Mondays and Tuesdays.  Simple spider vein conditions are those that are cosmetic and can be treated with liquid sclerotherapy.  This does not include foam sclerotherapy for larger varicose veins, which is administered by the doctor.

The cost is based on how much solution is used, so it is a cost efficient means of treating that ‘stubborn patch of veins’ or ‘clean up’ of small spider veins after larger varicose vein removal.  The cost is $100 for the first syringe (2cc) and $75 for each additional syringe.

spider veins

Spider veins can come in different sizes and severity. Depending on the severity of the spider veins, multiple sclerotherapy treatments may be required.

New patients or patients not seen within two years will be required a physician consultation first.  For more information or to schedule your consultation, call 858-550-0330.

Dr. Fronek teaches primary care doctors to care for patients with vein problems

Dr. Fronek was recently invited to discuss vein disorders with the Family Medicine Residency Program at Scripps Chula Vista.  The doctors-in-training were excited  to learn about the variety of problems that patients have with their veins – including  spider veins,  varicose veins,  blood clots, and leg ulcers.  Primary care doctors see patients with vein disorders every day, and yet very few medical schools or residency training programs include any information about these common problems.  Dr. Fronek and Dr. Bunke-Pacquette are committed to sharing their expertise with colleagues and are frequently asked to speak at medical meetings.  Primary care doctors, in particular, can often start patients with vein disorders on conservative treatment, including graduated compression stockings and regular exercise (walking is usually the best exercise for vein disorders), as well as certain supplements such as horse chestnut seed extract, that can alleviate the symptoms that many patients with vein disease suffer from.  Informed primary care doctors can also refer patients to a vein specialist when symptoms aren’t diminished with conservative treatment, if the varicose veins worsen while a patient is using compression and exercise, or if the patient suffers from a venous leg ulcer.